The national crisis in access to oral health care: a dental industry association responds.

What factors lead to innovative opportunities? Peter Drucker notes that some factors are changes within an organization, whereas others are changes that occur outside the organization.1 One type of change that occurs outside an organization and which history has shown to be a source of innovation is a national crisis. In this column, I examine the relationship between national crises and how one dental industry association, the American Dental Trade Association (ADTA), responded with an innovative approach. What qualifies as a national crisis, and how, in the past, has industry provided innovations to help the nation? Although many examples might be cited, as well as debated, our nation going to war certainly qualifies as a national crisis. At times of war, industry is often called on to innovate. For example, during World War II, when President Franklin Roosevelt challenged the leaders of the shipping industry to develop new methods of building ships to support a global war effort, Henry J Kaiser accepted the challenge and developed new methods of ship construction. The Liberty Ships, as they were called, were critical to a successful war effort by the United States.2 However, war is not the only example of a national crisis. Today, access to dental care is another crisis of national proportions that meets this definition. The magnitude of this crisis was recently brought to the attention of the American people in a report prepared by David Satcher, MD, PhD, Surgeon General of the United States from 1998 to 2002. In May 2000, Dr. Satcher issued the first-ever report, titled Oral Health in America: A Report of the Surgeon General.3 The report illustrates the profound disparities that affect those without knowledge or resources to achieve good oral care. Health disparities were defined as differences in access to health services between racial and ethnic groups, gender, and those with disabilities. To illustrate the disparity, the report notes that tooth decay—a childhood disease 5 times as common as asthma and 7 times as common as hay fever—occurs in about 25% of white children. By comparison, it occurs in 70% of the Native American population and about 40% in African American and Mexican American populations.3 One explanation for this phenomenon is that fluoridation is not available to all communities. Water fluoridation reaches 145 million people; this is at best only about 62% of those being supplied with public water.3 That means about 100 million Americans do not have access to fluoridated water and are in need of products that deliver fluoride. Moreover, for every child without medical insurance, almost 3 times as many are without dental insurance; ie, children from families without dental insurance are 3 times more likely to have unmet dental needs than insured children.3 Finally, each year in the United States, 30,000 people are diagnosed with mouth and throat cancer, and 8,000 die each year; that amounts to 1 each hour. Mouth and throat cancers make up the sixth most common cancer in all US men, and, more specifically, it is the fourth most common in African American men.3 These findings support the Surgeon General’s concluEdward F Rossomando, DDS, PhD, MS Professor and Director Center for Research and Education in Technology Evaluation University of Connecticut School of Dental Medicine Farmington, Connecticut [email protected]